Purpose: This study was carried out to assess the accuracy of ultrasonography in diagnosing and distinguishing the type of inguinal hernia, so that its use could be justified in the imaging of occult hernia or equivocal clinical examination findings. Patients and Methods: This study included 64 patients with symptoms suggestive of inguinalhernia that prospectively underwent a blinded sonography examination of the inguinal region and found to have inguinal hernia on sonography as well, and who could be followed up till the surgical exploration. The findings of combined physical examination and high resolution ultrasonography were correlated with the intraoperative (surgical) findings. Results: Sixty-four patients with symptoms of either groin pain or palpable groin bulge underwent ultrasonography of bilateral groin region. Of these patients, 6 went on to have bilateral inguinal hernia repair bringing the study total to 70 groins.The sensitivity of physical examination for indirect inguinal hernia in this study was 82.22% with 72% specificity and 84.09% positive predictive value and 69.23% negative predictive value. The hernial sac and the Inferior Epigastric Artery were successfully identified on every color Doppler sonography examination. The sensitivity of color Doppler ultrasonography for indirect inguinal hernia was 93.33%, the specificity was 80%, the positive predictive value was 89.36% and the negative predictive value was 86.96%. The overall accuracy of clinical examination in identifying the type of hernia correctly (direct vs indirect) was 78.57% while that of ultrasonography examination was 88.57%. Conclusion: This study concludes that ultrasound with color Doppler sonography can accurately diagnose inguinal hernias and its type which justifies its use in the assessment of occult inguinal hernia and thereby allowing improved treatment planning.